Term
| What is the definaition of pain? |
|
Definition
| An unpleasant sensory and emotional experience associated with actual or potential tissue damage while an individual in conscious |
|
|
Term
| What are relation of pain and consciousness? |
|
Definition
pain only occurs in conscious individuals;
Unconsiouness= no pain |
|
|
Term
| What are the relation pain and emotion and social factors? |
|
Definition
Pain implies an interplay among sensation and emotion (anxiety).
Measuring the response to painful stimulus with respect to physical sensation. |
|
|
Term
| What do local anesthetics do? |
|
Definition
Decrease nerve transmission: both peripheral and central
LA given systemically have a general anesthetic action
Depress myocardial conduction and contraction |
|
|
Term
| How do local anesthetics work? |
|
Definition
| Block Na+ ionic channels from inside nerve lead to block changes in membrane potential and lead to block generation of an action potential |
|
|
Term
| What are the component of GA? |
|
Definition
|
|
Term
|
Definition
Ranges from: no movement to noxious stimuli with normal muscle tone flaccid flaccid-paralysis
Minimum Alveolar Concentration |
|
|
Term
|
Definition
| Consciousness has many components |
|
|
Term
| What are GA: controlled Pain Response: Analgesia? |
|
Definition
Insensitivity to noxious stimulus
Sympathetic response (HR, BP) are surrogates for pain |
|
|
Term
| What are the advantages of GA: |
|
Definition
"Stilliness" for long period s
Facilitates physician control of: airway, breathing, circulaiton
Does not require patient cooperiation with surgeon
Permits surgery in different body regions stimultaneously |
|
|
Term
|
Definition
| Minimum Alveolar Concentration |
|
|
Term
|
Definition
| Agent conc. at which 50% of a test population does note move purposefully in response to a noxious stimulus |
|
|
Term
| What are volatile agents of MAC? |
|
Definition
| MAC for specific agent similar for different species & phyla |
|
|
Term
|
Definition
A gas, not a volatile fluid
Can not be used for GA by itself, but used to allow less of the potent agent to beused
Fast onset and offset (low solubility) |
|
|
Term
|
Definition
Can be used for sedation/analgesia
PONV
Long term exposure toxicity
nerve damage, fertility and teratogen |
|
|
Term
| What are Pre-Op Laboratory studies? |
|
Definition
No studies are required
No routine studies |
|
|
Term
| What are CV toxicity of Bupivacaine? |
|
Definition
Long acting LA
Highly Protein Bound-long action
At the toxic doses lead to Ventricular Tarch/ Ventricular Fibrillization
Predisposing factors to Toxicity: hypoxia, respiratory acidosis, pregnancy |
|
|
Term
| What are CV toxicity of Cocaine? |
|
Definition
is unique b/c it inhibits reuptake of catecholamines at nerve terminal
Potentiates action of Epi and Norepi |
|
|
Term
| What are CV toxicity of Cocaine? |
|
Definition
Hypertension, Tachycardia, Arrhythmias, Coronary insufficiency,
Sudden increase in BP associated with CVA |
|
|
Term
| What are CV toxicity of Cocaine? |
|
Definition
| Vasoconstriction when applied topically or injected lead to hypertension, MI |
|
|
Term
| What are the immediate Management of overdose LA? |
|
Definition
stop injection
100% O2 and IV access
Control seizures: BZP or propofol |
|
|
Term
| How is Amide and Ester LA deference? |
|
Definition
Amides tends to cause more toxic reactions (metabolized by liver) than esters (semicholesterase) slower degradations
But esters cause more allergic reactions |
|
|
Term
| What is the safe use of local anesthetics? |
|
Definition
| Know absorption at sites of injection: intercostal blocks greatest absorption, spinal negligible |
|
|
Term
| What are the effects when add Epi to LA? |
|
Definition
Causes local vasoconstriction:
slower absorption
Less systemic toxicity: can use more
Less surgical bleeding |
|
|
